微创经皮椎弓根螺钉内固定术对不稳定性胸腰椎骨折患者ODI评分的影响

Effect of minimally invasive percutaneous pedicle screw internal fixation on ODI score in patients with unstable thoracolumbar fractures

目的:探讨用微创经皮椎弓根螺钉内固定术治疗不稳定性胸腰椎骨折的效果及对患者Oswestry功能障碍指数问卷表(ODI)评分的影响。方法:回顾性分析2019年8月至2020年8月上饶市万年县第二人民医院收治的79例不稳定性腰椎骨折患者的临床资料。按照手术方法的不同将其分为A组(n=38)与B组(n=41)。对A组患者进行传统的切开椎弓根螺钉内固定术,对B组患者进行微创经皮椎弓根螺钉内固定术。比较两组患者的手术相关指标(包括手术时间、术后下床活动时间、术后住院时间、术中失血量)、术后并发症的发生率及ODI评分。结果:B组患者的手术时间、术后下床活动时间和住院时间均短于A组患者,其术中失血量少于A组患者,差异有统计学意义(P<0.05)。B组患者术后并发症的发生率为7.32%,A组患者术后并发症的发生率为31.58%,组间相比差异有统计学意义(P<0.05)。术后3个月,两组患者的ODI评分均低于术前,且B组患者的ODI评分显著低于A组患者,差异有统计学意义(P<0.05)。结论:对不稳定性胸腰椎骨折患者进行微创经皮椎弓根螺钉内固定术能减少其术中失血量及术后并发症,缩短其手术时间及术后恢复时间,促进其胸腰椎功能的恢复。

Objective:To investigate the effect of minimally invasive percutaneous pedicle screw internal fixation in the treatment of unstable thoracolumbar fractures and its impact on the Oswestry Disability Index(ODI)score.Methods:The clinical data of 79 patients with unstable lumbar fractures admitted to the Second People’s Hospital of Wannian County,Shangrao City from August 2019 to August 2020 were retrospectively analyzed.According to different surgical methods,they were divided into group A(n=38)and group B(n=41).Patients in group A were treated with traditional open pedicle screw internal fixation,and patients in group B were treated with minimally invasive percutaneous pedicle screw internal fixation.The surgery-related indicators(including operation time,postoperative ambulation time,postoperative hospital stay,intraoperative blood loss),incidence of postoperative complications and ODI score were compared between the two groups.Results:The operation time,postoperative ambulation time and hospital stay in group B were shorter than those in group A,and the intraoperative blood loss was less than that in group A,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in group B was 7.32%,and that in group A was 31.58%,and the difference between the two groups was statistically significant(P<0.05).At 3 months after operation,the ODI score of patients in both groups was lower than that before operation,and the ODI score of patients in group B was significantly lower than that of patients in group A,and the difference was statistically significant(P<0.05).Conclusion:Minimally invasive percutaneous pedicle screw internal fixation for patients with unstable thoracolumbar fractures can reduce intraoperative blood loss and postoperative complications,shorten the operation time and postoperative recovery time,and promote the recovery of thoracolumbar function.